Maternal and Fetal Outcome in HELLP Syndrome: An Observational Study

Anitha, G S; Shivamurthy, Geetha; Krishnappa, Tejeswini Kolige; Chethan, R.

doi:10.5005/jp-journals-10006-1779

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…In a study by Ni and Cheng on early-and late-onset preeclampsia, concluded that the early-onset preeclampsia is a distinct and more severe clinical entity with earlier gestational age onset and delivery. [4][5][6] In our study, the significant association was found between the decreased SpO 2 level and adverse maternal outcome (p < 0.0001). Srivastava et al, in their study found that SpO 2 successfully predicted adverse maternal outcome.…”

Section: Discussionsupporting

confidence: 54%

Prediction by fullPIERS Model (Preeclampsia Integrated Estimate of Risk) in Preeclampsia Patients for Adverse Maternal and Neonatal Outcomes

Singh¹,

Yadav²,

Ahmad³

2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Introduction:Hypertensive disorder of pregnancy is one of the leading causes of maternal and perinatal mortality worldwide. Preeclampsia complicates 2-8% of pregnancies globally. Despite the serious clinical consequences, there is currently no effective preventive measure for preeclampsia; hence, the focus has shifted to identifying good predictors for diagnosing the severity of preeclampsia. Material and methods: This was a prospective cohort hospital-based study done in our Department of Obstetrics and Gynaecology, SN Medical College, Agra, Uttar Pradesh, India over a period of 12 months from January 2020 to January 2021. A total of 400 women were found to be eligible for the study after meeting inclusion criteria. All patients underwent detailed evaluation and investigation and the risk was calculated using the preeclampsia integrated estimate of risk (fullPIERS) calculator. All patients were followed weekly till delivery. Adverse maternal and fetal outcome were assessed. If the predicted probability of the adverse outcome came out to be ≥30%, then the case was considered as high risk. T-test and Chi-squared test were used for statistical analysis as appropriate. Results: Considering our cut-off value ≥30% in our study, out of 384 patients, 82 were categorized into high-risk group; among them, 54 (65.85%) patients had adverse maternal outcome (χ 2 = 96.413, p ≤ 0.0001). Among 377 patients, excluding seven women who expired in antenatal period, 75 patients (19.89%) were categorized into high-risk group (≥30% predicted probability), among them, 59 (78.67%) patients had adverse fetal outcome (χ 2 = 96.413, p ≤ 0.0001). Conclusion:The fullPIERS model successfully stratifies population into clinically relevant high-risk categories by using few important clinical and biochemical parameters and does not require extensive laboratory testing. It is economically feasible and quick to use, and predicts probability of an adverse outcome. Thus, the timely referral to higher center will help in having a significant impact in reducing the maternal morbidity and mortality; and perinatal morbidity and mortality associated with preeclampsia in low resource settings.

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Section: Discussionsupporting

confidence: 54%

Prediction by fullPIERS Model (Preeclampsia Integrated Estimate of Risk) in Preeclampsia Patients for Adverse Maternal and Neonatal Outcomes

Singh¹,

Yadav²,

Ahmad³

2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…These adverse/poor outcomes have previously been documented and underline the role hypoalbuminemia plays in HELLP syndrome. 3,[5][6][7][8][21][22][23] The current study was limited by its retrospective nature so that it could not determine the causal impact of hypoalbuminemia on maternal and perinatal outcomes among the HELLP cases. Furthermore, since it is a single-institution study, the number of patients included is also rather limited and may result in an inadequately powered study.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 However, some scholarly opinion believe that the syndrome may evolve as a separate entity since it can manifest without preexisting features of severe preeclampsia as a precursor condition. 3,4 The syndrome is one of the dreaded complications with the potential for catastrophic consequences in pregnancy associated with high maternal and perinatal morbidity and mortality. [4][5][6] The cardinal underlying pathophysiology of HELLP syndrome is poorly understood and ill-defined to date.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 The reduction of plasma albumin level (hypoalbuminemia) in cases of HELLP syndrome has been reported in association with adverse/poor maternal and perinatal outcomes. 3,[5][6][7][8] However, these previous reports have largely been documented from western populations with a dearth of data within our region. 7,8 Hence, the present study was conceived to evaluate the status of plasma albumin levels and the relationship between hypoalbuminemia and adverse/poor maternal and perinatal outcomes among cases of HELLP syndrome in Port Harcourt, Nigeria.…”

Section: Introductionmentioning

confidence: 99%

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Hypoalbuminemia Predicts Poor Pregnancy Outcome among Cases of HELLP Syndrome in Nigeria

Amadi

2021

Int J Health Sci Res

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Background: The current study determined the status of plasma albumin and the relationship between hypoalbuminemia and adverse/poor pregnancy outcomes among cases of HELLP syndrome (HELLPsyn) in Port Harcourt, Nigeria. Methods: A retrospective cross-sectional study was conducted among women diagnosed with HELLPsyn in the University of Port Harcourt Teaching Hospital (UPTH) between 2011 and 2020. Data of all eligible cases were extracted from hospital registers, case notes, nurses’ charts, laboratory, and medical files using pretested datasheet and analyzed. Results: Two hundred and ten (210) HELLPsyn cases certified the eligible criteria and were included in the analysis. The overall hypoalbuminemia was recorded among 140(66.6%) of which 73(52.1%) and 67(47.9%) were in the clinically significant hypoalbuminemic and clinically insignificant hypoalbuminemic subgroups, respectively. The overall hypoalbuminemia and the clinically significant hypoalbuminemia subtype were more predominant among the severe HELLPsyn cases. The clinically significant hypoalbuminemic HELLP cases had increased risk of acute kidney injury (OR:8.456;95%CI:6.854-11.345), sepsis/infection (OR:4.346;95%CI:2.761-6.709), intensive care unit admission (OR:6.412;95%CI:4.356-8.104), and emergency cesarean section (OR:2.308;95%CI:1.206-3.896) compared to the normoalbuminemic/clinically insignificant hypoalbuminemic HELLP cases. Offspring of the clinically significant hypoalbuminemic HELLP cases also had increased risk of preterm delivery (OR:6.843;95%CI:4.346-8.766), intrauterine growth restriction (OR:3.408;95%CI: 2.166-4.988), birth asphyxia (OR:5.233;95%CI:3.764-7.412), and special care baby unit admission (OR:2.077;95%CI:1.106-3.674) compared to the normoalbuminemic/clinically insignificant hypoalbuminemic HELLP cases. Conclusion: Hypoalbuminemia, especially the clinically significant hypoalbuminemia subtype, is associated with adverse/poor maternal and perinatal outcomes among cases of HELLPsyn. However, we recommend further studies with a robust design to evaluate the clinical relevance of our findings. Key words: KHELLP syndrome, hypoalbuminemia, clinically significant hypoalbuminemia.

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Clinical Ability of Neutrophil–Lymphocyte Ratio in Pregnancy as a Predictor of Preeclampsia

Singgih¹,

Firmansyah²,

Dewi³

2021

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim and objective: Preeclampsia is part of the hypertension spectrum that occurs during the pregnancy period, especially when the gestational age is 20 weeks or more. Preeclampsia has a broad impact not only on pregnant women but also on the fetus they contain. It is said that in preeclampsia, there is an increase in inflammatory stimulation and an abnormal immune response so that routine blood values increase. Neutrophil-lymphocyte ratio (NLR) values reported in several studies have risen notably in the incidence of preeclampsia. Materials and methods: A cross-sectional observational analysis study was conducted on 924 pregnant respondents from January to December 2019 at Cimacan District Hospital, Cianjur. Statistical analysis test of the average difference between the two groups and the prediction test of NLR values was conducted between the healthy pregnant women group of 838 respondents and the group of 86 pregnant women with preeclampsia. Results: In statistical tests regarding the differences in the mean of the two groups, a significant NLR value was obtained (p = 0.004). Then the NLR value was tested again by the receiver-operating characteristic (ROC) curve method, and the results of the area under the curve (AUC) on the variable values were obtained in the form of AUC: 0.595/p-value: 0.035. Conclusion and clinical significance: Despite the differences in the mean NLR in the two groups, however, the NLR of women in predicting the incidence of pregnancy with preeclampsia is very low.

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Maternal and Fetal Outcome in HELLP Syndrome: An Observational Study

Cited by 3 publications

References 14 publications

Prediction by fullPIERS Model (Preeclampsia Integrated Estimate of Risk) in Preeclampsia Patients for Adverse Maternal and Neonatal Outcomes

Prediction by fullPIERS Model (Preeclampsia Integrated Estimate of Risk) in Preeclampsia Patients for Adverse Maternal and Neonatal Outcomes

Hypoalbuminemia Predicts Poor Pregnancy Outcome among Cases of HELLP Syndrome in Nigeria

Clinical Ability of Neutrophil–Lymphocyte Ratio in Pregnancy as a Predictor of Preeclampsia

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